A blue-ribbon commission to examine health care in Maine, proposed last week by Gov. Angus King, is an important opportunity to address issues of cost and access to medical care. The commission should be given enough resources to do a thorough job and be willing to provide bold alternatives to a health care system that currently is squeezing more and more people out.

In making his announcement Tuesday, Gov. King emphasized prevention as a way to cut health care costs and make coverage more affordable for everyone. Giving people more responsibility for their own health and opportunities to make healthy choices are fine ideas that have been shown to be effective in Maine. In Franklin County, for instance, a 25-year-old program uses a budget of just $20,000 a year to improve cardiovascular health through screenings, counseling and referral. Its results show a 9 percent greater drop in deaths from heart disease and a 7 percent greater drop in total deaths compared with the entire state. The decline resulted in approximately 123 fewer deaths and 615 fewer major hospitalizations due to heart disease, and major savings to everyone involved.

But as valuable as prevention programs may be, they would not address genetic illnesses and are unlikely to reverse a trend that now sees 180,000 Maine residents without health care coverage.

For those issues, a commission will have to think big — although not necessarily big government. To start, it will need information about why so many people have lost their insurance — that is, why health care costs have risen at a rate well above inflation and how the changing job market in Maine exacerbates the problem. And it will need improved data on utilization, particularly by the uninsured: What kind of health care are they receiving, at what point in their illnesses and how is that cost being covered? It should provide solutions to the rising costs of pharmaceuticals, once a small portion of the health care bill but growing larger by the year.

Equally important to examine is coverage for mental health problems and the costs to Maine when these are left untreated. It will need to come to grips with Medicaid/Medicare that, on the one hand, have low reimbursements that force medical facilities to shift costs to private-pay patients and, on the other, cover some of the state’s sickest residents when no other insurer could afford to.

What the commission cannot be is an excuse for inaction in the upcoming legislative session. Any recommendations the commission makes could require years to take effect and years more to make a measurable difference in access to care. A proposed expansion of coverage for working, low-income parents, for instance, makes sense whether or not a prevention program is in place. And cholesterol clinics cannot replace the need for improved access to prescription drugs for the elderly.

The commission might rely on information from a similar task force in 1995, the Maine Health Care Reform Commission, which devised several ways of covering far more residents. The chairman of that commission, Dr. Robert Keller, said at the time that, “This commission believes strongly in the concept of universal health care coverage for all of Maine’s citizens. It has been our guiding principle and must be the ultimate goal.” That should be the aim of the governor’s new commission, as well, although it should keep in mind that private insurers — not just government — can offer universal care, with the state acting as a million-person business interested in negotiating with an HMO.

Gov. King’s announcement comes as the state’s largest insurer, Blue Cross, is in the process of being subsumed by a still-larger firm, and another major insurer, Tufts Health Plan, is leaving the state as fast as its overseers will allow. In the coming years, Maine could have even fewer insurers available to provide health coverage — moving the state toward living with less competition without the benefits of a more accessible system. An aggressive commission could prepare the state for these uncertainties and the many others that lie ahead.